Abstract: :
Purpose:To compare the anatomic and visual outcomes achievedby pars plana vitrectomy (PPV) and scleral buckling (SB) forthe treatment of uncomplicated primary rhegmatogenous retinaldetachment (PRRD).Methods:In a prospective, longitudinal descriptiveand experimental study, eight consecutive patients of both genderswith PRRD eligible for treatment with SB and no more than proliferativevitreo-retinopathy grade B, where enrolled. They were randomlyassigned to PPV using a high speed (1200 cpm) vitrectomy handpiece, endolaser and gas tamponade (20% SF6) or to SB procedure.Surgery success rate (complete reattachment three months followingsurgery), complications rate, as well as changes in best correctedvisual acuity (BCVA), intraocular pressure (IOP), ocular axiallength, multifocal electroretinography (mERG), optic coherencetomography (OCT) and patient’s discomfort were recordedand compared between the two surgical techniques.Results:Eightphakic eyes of eight patients were included (four in each group).In the PPV group, ages ranged between 20 and 65 years (mean45). Three eyes had a macula-off detachment. Initial BCVA rangedfrom hand motion to 20/100. Primary reattachment was achievedin all cases. One eye re-detached two weeks after surgery andsubsequently underwent a successful combined buckling and vitrectomysurgery. Final visual acuity improved in all cases (1.75 lineon average), and ranged between 20/200 to 20/70. Two patientshad elevated ocular pressure, controlled by topical antihypertensives.Posterior subcapsular cataract developed in two eyes. In theSB group, patients ages ranged between 14 and 52 years (mean37). Initial BCVA ranged from 20/400 to 20/200. Four had a macula-offdetachment. Reattachment was achieved in all cases. Final visualacuity improved in all cases (3.75 lines on average) and rangedfrom 20/200 to 20/30. Extraocular muscle imbalance and diplopiadeveloped postoperatively in one patient. OCT indicated normalpostoperative retinal thickness range in both groups eyes. mERGamplitudes improved postoperatively in all eyes. No differencein improvement rate or amplitudes was found between the twogroups. Patient’s postoperative discomfort was similarin both groups.Conclusion:This study results suggest that althoughboth techniques are anatomically and functionally effectivefor the treatment of uncomplicated PRRD, SB procedure may beassociated with higher primary success and lower postoperativecomplication rates.